Background Checks: Do Hospital Records Affect Employment?

Whether or not hospitalization shows up on a background check depends on the type of background check and the laws in the state or country where it is conducted. In general, medical history is private and protected by law, and healthcare professionals can face severe consequences for disclosing information without consent. However, certain positions, such as those in law enforcement, may require an in-depth look at mental health issues, and some US states have released non-conviction mental health records to employers. Criminal record checks are common in pre-employment screenings, and hospitals may consult state registries to ensure that an applicant is not a registered sex offender.

Mental health records and hospitalizations

Generally, mental health diagnoses are included in a person's medical record and are protected by law. Healthcare professionals are bound by confidentiality and can face severe consequences, including job loss, for disclosing any information without the individual's explicit consent. However, this protection does not apply to drug screenings, which can be part of the background-checking process.

In certain cases, such as for security and safety positions in law enforcement and military agencies, a mental health check is required. This typically involves an in-depth look at any previous mental health issues. Additionally, some states may have access to mental health records through fingerprinting requirements for employment or licensing.

In the context of gun ownership, mental health records play a significant role in background checks. The National Instant Criminal Background Check System (NICS) is a federal database used to check individuals' eligibility to purchase firearms. While medical records are generally protected by the Health Insurance Portability and Accountability Act (HIPAA), there has been a push for improved record-sharing of mental health information in background checks for gun purchases. This is due to incidents where dangerously mentally ill individuals passed background checks and committed violent acts. As a result, the number of mental health records in the NICS system has tripled since 2011, leading to a significant increase in blocked gun sales to seriously mentally ill individuals.

It is important to note that the impact of mental health records on background checks may vary depending on the state and the specific circumstances.

Criminal record checks

There are two main types of criminal record checks: personal identifier searches and fingerprint searches. A personal identifier search requires the applicant's name, date of birth, and social security number. This type of search costs $15.00 per request and the results are considered a ""possible match", including open records such as convictions, arrest information, and pending charges. A fingerprint search requires a completed applicant fingerprint card (FD-258) and costs $20.00 per request. The results of a fingerprint-based search are considered a ""positive match"" and will provide closed or complete records, including all criminal history data, charges, and expunged records.

It is important to note that criminal record checks are subject to various laws and regulations, such as the FCRA and EEOC, and employers must ensure their hiring and screening policies are consistent and compliant to prevent discrimination and avoid litigation. Additionally, medical and mental health information is typically not disclosed during background checks and is protected by laws such as HIPAA. However, drug screenings may be included as part of the background checking process.

Drug screenings

A person's medical history is typically kept confidential and is not disclosed during background checks. However, drug screenings are an exception and can be included as part of the background checking process. Drug screenings are often used by employers to determine if a candidate's habits and values align with the company's.

Employers have the discretion to include drug tests as part of their pre-employment screening or background checks. These drug tests can take the form of hair specimen analysis, on-site oral fluid screens, or breath alcohol tests, with each method varying in its detection window. Hair testing, for example, can provide a 90-day window into an individual's drug history, while urine or oral testing is more suitable for ongoing, random testing due to its shorter detection window of about one week.

It is important to note that drug testing laws and regulations can vary depending on the state and local government. While marijuana use remains illegal under federal judgment, some states have legalized its recreational or medicinal use. Despite this, employers can still legally test for marijuana and make employment decisions based on the results.

Certain positions, such as those in security, law enforcement, or the military, may require an in-depth look at mental health history, including any episodes that provoked a police response. However, some jurisdictions, like Toronto, have moved away from this practice, choosing not to release non-criminal mental health records to employers conducting background checks.

Medical history privacy

In the United States, a person's medical history is considered private and protected by law. The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that safeguards an individual's health information from being disclosed without their consent. This law ensures that an individual's medical records are kept confidential and are not shared without their explicit permission. Healthcare professionals are bound by this confidentiality and can face repercussions, including job loss, for disclosing any information without the patient's consent.

However, it is important to note that medical history can impact employment prospects. While employers commonly conduct background checks to maintain a safe workplace, these checks typically focus on criminal records, credit history, employment history, and education history. An individual's healthcare information is generally not accessible during these screenings, and laws like HIPAA protect health records from being disclosed.

That being said, there are certain exceptions and limitations to medical privacy. For example, drug screenings may be part of the background checking process and can reveal information about an individual's health. Additionally, certain positions, such as those in law enforcement or security, may require mental health evaluations as part of the hiring process. In such cases, previous mental health issues may be examined in detail. Furthermore, state laws may vary, and some states may have specific practices regarding the release of mental health records to employers.

It is worth noting that individuals have legal recourse if their medical privacy is violated. The Computer Fraud and Abuse Act (CFAA) provides individuals with the right to sue if their protected medical information is accessed without authorization and causes monetary loss or impacts their medical care. Additionally, individuals can file consumer complaints with relevant authorities, such as the Texas Attorney General's Office, if they believe their health information has been unlawfully shared.

While medical history privacy is generally upheld, there may be situations where an individual's medical information can be shared without their consent. This includes sharing with family members or others involved in an individual's healthcare, reporting public health concerns, or making required disclosures to law enforcement. Nonetheless, these disclosures are typically limited and must comply with relevant privacy laws and regulations.

State-specific variations

In the United States, there is no federal law requiring hospitals to run background checks. However, hospitals typically conduct stringent background checks to mitigate risk and comply with state laws. While an individual's medical history is generally considered private, there are some variations and exceptions at the state level.

In certain states, hospitals may only access 7 to 10 years of criminal history during background checks, while other states report all convictions regardless of their age. Hospitals may consult local courts, state databases, or conduct nationwide searches as part of their background screening processes.

Mental health records are another area where state-specific variations exist. While mental health diagnoses are typically not included in pre-employment screenings, certain security and safety positions, such as law enforcement and military agencies, may require an in-depth review of previous mental health issues. State governments have significantly increased the number of mental health records submitted to the FBI's gun-purchase background check system, the National Instant Criminal Background Check System (NICS). However, it's important to note that medical records are protected by the Health Insurance Portability and Accountability Act (HIPAA), which prohibits healthcare providers from disclosing patient information without consent. Still, there are exceptions, such as when individuals are involuntarily committed to mental institutions, and states have the option to submit additional mental health records to the NICS.

Additionally, abuse registries, such as child and elder abuse records, may be accessible to Consumer Reporting Agencies (CRAs) in specific states, particularly for positions in the healthcare industry.

Frequently asked questions